Impact of discharge education by clinical pharmacists on patients' adherence to post‐percutaneous coronary intervention medications: A retrospective cohort study using real‐world data

Abstract

BackgroundSecondary prevention post myocardial infarction by optimizing secondary prevention cardiovascular medications is important; however, adherence to these medications is essential to achieve benefits. Nevertheless, the impact of education provided by clinical pharmacists to patients post primary percutaneous coronary intervention (PCI) has not yet been evaluated in a real‐world context.MethodsThis retrospective observational cohort study aimed to assess the impact of education provided by clinical pharmacists compared with other health care providers on adherence to post‐PCI medications and clinical outcomes among patients with ST‐elevation myocardial infarction (STEMI). This study included all patients admitted with STEMI to Heart Hospital in Qatar between 1 January 2016 and 31 December 2018. Adherence was assessed by medication availability 80% of the time, which was monitored by the rate of prescription refill in the year after discharge.ResultsA total of 1334 patients were included. The majority of patients included were male (96%) and Asian (78%), with a mean age of 51 years. Only 26% of the study population were educated by clinical pharmacists, while the remaining were educated by other health care professionals upon discharge. Adherence to aspirin, P2Y12 inhibitors, statins, and beta‐blockers was significantly better among patients who were educated by clinical pharmacists (aspirin, 59% vs 47%; adjusted odds ratio [aOR], 1.5; 95% confidence interval [CI], 1.1‐1.9; P = .002; P2Y12 inhibitor, 58% vs 47%; aOR, 1.5; 95% CI, 1.1‐1.9; P = .004; statin, 55% vs 46%; aOR, 1.3; 95% CI, 1.0‐1.7; P = .038; beta‐blocker, 46% vs 37%; aOR, 1.4; 95% CI, 1.1‐1.8; P = .018). However, there was no difference in re‐hospitalization for acute coronary syndrome or all‐cause mortality among patients who were educated by clinical pharmacists upon discharge compared with those who were educated by other health care providers.ConclusionMedication counseling provided by clinical pharmacists significantly improved adherence to post‐PCI medications among patients with STEMI.

Addressing the effectiveness of health literacy programs within the Gulf Corporation Council: an integrative review

“…(2016) used to teach male adolescents about smoking prevention. In contrast, sessions designed for adult participants were based on didactic lecturing and discussions ( Bakarman et al ., 2019 ; Rahhal et al , 2021 ).…”

“…It was noted that patient compliance with the comorbidity regimen is a valued parameter in improving the effectiveness of health literacy programs. In the study by Rahhal et al , (2021) , investigators assessed compliance with the regimen of adult patients ( n = 1334) who underwent percutaneous coronary intervention (PCI) and received clinical pharmacists’ educational interventions during discharge from the hospital. These investigators found significant adherence to post-PCI medication.…”

“…(2016) examined the efficacy of a smoking prevention program on smoking-related cognitions and behaviour for male adolescents. A retrospective observational cohort study by Rahhal et al , (2021) compared the impact of clinical pharmacists and other healthcare providers’ education on patients’ adherence to post-percutaneous coronary intervention medication. Rabbani et al , (2019) explored the effectiveness of a community-based educational intervention in promoting breast cancer screening and health behaviour changes.…”